| Learning Objective #1: Identify four common barriers to intuitive decision making in the clinical arena | |||
| Learning Objective #2: Describe the differences in perception of barriers from the view of the administrator, the chief nurse executive, the unit manager and the staff levels of acute care |
Objectives: To validate the reluctance to use intuitive decision making in the clinical arena. To identify the perceptions of acute care leadership and staff regarding barriers to intuitive nursing practice. Design: This two part exploratory study provides a qualitative descriptive analysis of the perceptions of acute care medical/surgical registered nursing staff and their respective leadership. Population, Sample, Setting, Years: Seven acute care hospitals participated in this study. A total of 23 administrative team members (CEO, Nurse Administrator, and Unit Manager) and 146 registered nurses from medical/surgical units completed interviews and surveys in 2000-2001. Concept or Variables Studied Together or Intervention and Outcome Variable(s): The definition of intuition, frequency of use of intuitive decision making, perceived organizational support and examples of situations in which a nurse did not take appropriate clinical action for a patient who was intuitively felt to be "in trouble." Method: Data was collected using both a written survey instrument for the staff and a semi-structured oral interview process for leadership. Findings: Leadership reported using intuition which exceeded previously reported frequency rates of professionals in all industries.
Physician behaviors and leadership perspectives are the major barriers evident in the use of intuition in clinical practice. This is the first study to offer leadership validation of these barriers, and to identify a significant "disconnect" among the levels of staff and management. Conclusions: Consequences because of barriers to action relative to intuitive insights were considerable and included examples of patient deaths, delays in care, worsening conditions and additional surgical interventions. Frustrated regarding nurses’ lack of confidence, leadership indicates a desire to have nurses use more of their own judgment and take action Implications: Further study is recommended, with emphasis on the inclusion of physicians to determine their perspective and acceptance/support of intuitive decision making.
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Back to 14th International Nursing Research Congress
Sigma Theta Tau International
10-12 July 2003